Hair Loss Treatment History
Since the beginning of recorded history, men and women have searched out cures for hair loss. Over the last 5,000 years, there have been many cosmetic treatments that give the illusion of more hair, a few medical treatments that use drugs to affect the hair follicles, and some surgical treatments that remove bald areas or move hair follicles around. And these are just the treatments that work.
Countless herbal solutions, medical-sounding cosmetics, nutritional supplements, pills, oils, lotions, and shampoos have been advanced, with little or no result. Electric shock devices, ultraviolet light-emitting instruments, LED, laser, and vacuum-cap machines have all been alleged to help stimulate the follicles to grow hair. Even spiritual solutions have been advanced. In fact, prayer may indeed be a better solution than most of the treatments that follow.
What is noteworthy about the history of hair loss treatment is this: despite real advances in genuinely effective cosmetics, medical treatments, and surgical procedures, bogus hair loss solutions continue to be marketed today with astonishing success. Their sales are astonishing, that is. Despite their wild claims, most of the products marketed as hair loss solutions don’t have a scientifically measurable positive effect. In other words, they don’t stop hair loss or grow new hair. But people are so concerned about hair loss, they want to believe some “miracle cure” will work for them.
Wigs and hairpieces of various sorts were popular among upper class Assyrians, Sumerians, Cretans, Carthaginians, Persians, and Greeks in the Fertile Crescent area of the Middle East. Around this same time period, a compendium of medical knowledge that included prescriptions for hair loss treatment was passed on from generation to generation among Fertile Crescent area healers
1553 BC
The Ebers Papyrus, discovered in Luxor, Egypt, is believed to include medical information drawn from the earlier described compendium of medical knowledge which was collected 2,000 years earlier. The Ebers Papyrus is the oldest complete medical text ever found, and it is devoted to treatments for various skin diseases and cosmetic conditions. It includes the oldest known written prescription for treating baldness: a mixture of iron oxide, red lead, onions, alabaster, honey and fat from a variety of animals including snakes, crocodiles, hippopotamuses and lions. The mixture was to be swallowed, after first reciting a magical invocation to the Sun God:Wigs were popular among Egyptian royalty at this time as well, and a number of elaborate and well-preserved hairpieces have been found in tombs by archaeologists. Many Egyptian wigs were ornate creations constructed of linen fiber as well as human hair, while others made of metal were more helmet-like. As an example of the importance hair played in certain cultures, certain Egyptian royalty also used “facial hair wigs,” specifically fake beards, to signify power. Both male and female royalty wore the fake beards.
420 BC
In ancient Greece, Hippocrates, the Father of Modern Medicine, tried many medical solutions for his own progressive hair loss, and he was the first to describe an effective surgical solution to hair loss. One of his medical formulas was a mixture of opium, horseradish, pigeon droppings, beetroot, and various spices that were applied to the head. It didn’t work. Hippocrates eventually became so bald that two thousand years later, we refer to extreme cases of hair loss as “Hippocratic baldness.”
1624
Over 1,600 years later, King Louis XIII of France began wearing a full wig to camouflage his thinning hair. Soon, other members of the court followed his example, regardless of their own hair condition. Wigs became symbols of power. The height, length, and bulk of wigs increased with eachdecade, and giant powdered wigs soon became the fashion in all French courts.
In England, King Charles II was restored to the throne after his exile in Versailles where he had been exposed to the French wig craze. The English were not to be outdone by the French. Within a short time, more elaborate giant powdered wigs were worn in English courts than had ever appeared in France
1700S
Upper class American colonists picked up the wig fashion, and by the late 18th century most wealthy people wore false hair to signify their elevated class. However, the American War of Independence and the subsequent French Revolution caused the look of royalty and elevated class distinction to fall out of favor, and wigs pretty much disappeared from the scene.
This was the heyday of the “snake oil” salesmen, and for the next hundred years bottles of hair loss cures with names like “Mrs. Allen’s World Hair Restorer,” “Ayers Hair Vigour,” “East India Oil Hair Restoration,” “Skookum Root Hair Growth,” “Westphall Auxiliator,” “Imperial Hair Regenerator” and the ever popular “Barry’s Tricopherous” were sold to hopeful buyers seeking a cure for their hair loss from “modern medicine.”
A hundred years later, “snake oil” cures for hair loss continue to be marketed, except now they’re sold by beauty salons and barber shops, by mail, cable television, over the Internet, and with great success to listeners of talk radio programs. The names of the products have changed to things like Helsinki Formula, Foliplexx, Revivogen, Nioxin, Kevis, and Fabao to name just a few. The same outlandish performance promises fool vulnerable consumers.
1900S
The wearing of hats by nearly all men in urban areas around this time was blamed for causing hair loss. Anti-hat advocates urged men to let their hair follicles “breathe” and to allow their scalps to enjoy the benefits of “sun baths” and “air baths.” No one seemed to notice the countless men who wore hats who did not lose their hair.
The industrial age brought new inventions to the marketplace, solving a countless number of life’s little problems. In St. Louis, the Evans Vacuum Cap Company marketed a suction device that: “...exercises the scalp and helps to circulate stagnant blood, feeding the shrunken hair roots, and causing the hair to grow...”
1920S
People still suffered from hair loss, and modern science contin-
ued to work on this problem. Devices using the miracle of electric-
ity started to replace mechanical hair restoration machines. In the United States, exotic gas-filled clear glass combs with names like “Master Violet Ray” and “Super Marvel” glowed with purple light as they generated an electric charge. The electrified comb was raked across the scalp to stimulate hair growth. Amazingly, some of these devices continued to be sold until the 1950s.]
1925
The Allied Merke Institute in New York City began sell-
ing the Thermocap Treatment device, claiming to stim-
ulate circula-
tion, cleanse clogged-up pores, and n ourish d ormant hair bulbswith heat and blue light from a special actinic quartz ray bulb. The quartz ray treatment took only fifteen minutes a day. Along with the Thermocap device, the complete Treatment included the Merke Tonic, Merke Dandruff Treatment, and Merke Shampoo Cream.
In Cincinnati, the Crosley Radio Corporation diversified a bit from radios, and offered an electric scalp vacuum device claimed to be a “Therapeutic Method for Hair Growth” and called it the X-ER-VAC. It was available for home, local clinic, barbershop, and beauty shop use.
1952
Dr. Norman Orentreich, a dermatologist in New York City, was doing a study on vitiligo, a skin pigment disorder. His study involved transferring patches of skin from one part of a patient’s body to another. It was noted that a skin graft taken from a hair bearing area, when placed in a non-hair bearing area, continued to grow hair at the new site. Soon after making this observation, Dr. Orentreich placed ten punch grafts bearing hair on the front part of the scalp of a patient with severe frontal hair loss. The grafts continued to grow hair in the new location. Dr. Orentreich reported the successful results of the first hair transplant procedure performed in the United States in a paper submitted to the Archives of Dermatology. The reviewers of that journal said the reported results “were not possible” and rejected the paper.
1960S
Despite scientific evidence that genetics was the cause of pattern hair loss, other theories continued to be presented by people whose hair loss solution happened to cure the particular theorized cause. Scalp tightness, for example, was advanced as the reason for hair loss, and surgical procedures to “loosen the scalp” with incisions were performed.
LATE 1960S
The miracle of modified acrylic fiber allowed mass-produced wigs that had the look of human hair to be constructed by machine and sold inexpensively. Soon a whole range of wigs, hairpieces, and other “hair supplements” were introduced, and they were even sold at Tupperware-style “wig parties” in suburban areas.
In the United States, I began my residency training with Dr. James Burks, one of the first doctors to perform hair transplants on a regular basis in the United States. During my residency, I performed hair transplantation procedures every week for three years.
1970S
The “Bald is Beautiful” movement enjoys a brief moment in the spotlight. Bald actors and celebrities such as Yul Brynner and Telly Savalas, appear on TV and in movies with completely bald heads, a concept almost unheard of previously
1979
Drawing attention to the significance of hair, bald-headed female celebrities begin to appear in the media, including and actress Sigourney Weaver in the movie Alien (1979), and later, singer Sinead O’Connor on her album The Lion and The Cobra (1988).
1980S
In the field of hair transplant surgery, full-size grafts (“plugs”) are replaced first by minigrafts and then soon after by micrografts. The new technique of micrografting allows patients to avoid the “under construction” look, and achieves a more natural overall result than most full-size graft procedures.
1984
1988
Minoxidil lotion is the first medication approved by the FDA for treating hair loss. It is sold by prescription only in a two percent solution under the brand name Rogaine.
1988
Dr. Bob Limmer, a dermatologist and hair restoration surgeon practicing in Texas, has his surgical team use stereo microscopes rather than less powerful magnifying glasses while preparing micrografts. The more powerful magnification helps his team to preserve naturally occurring clusters of hair follicles in the donor tissue. This advance in micrografting reduces cutting and the risk of graft failure, while producing grafts that grow more naturally than arbitrarily cut single-hair, two-hair, and three-hair grafts. In 1991, Dr. Limmer publishes an article in Hair Transplant Forum International describing what would become known as follicular unit micrografting.
1989
The FDA restricts all non-prescription hair creams, lotions, and cosmetic products from making medical claims that they can grow hair or prevent baldness. Manufacturers respond by altering their advertising slightly to make medical-sounding claims without actually stating that the products can grow hair.
1990
Another generic medication called finasteride is shown to reverse hair loss, and it is even more effective than minoxidil in preventing
More bald-headed male celebrities are seen in the media, including basketball superstar Michael Jordan, and Star Trek Next Generation’s Captain Picard, portrayed by actor Patrick Stewart.
1991
Hair Club for Men introduces a unique method of eliminating hairpiece “weaves,” by using an adhesive to attach the hair appliances directly to the scalp. Glued-on hairpieces soon become the industry standard.
1993
The electric shock method of “awakening” hair follicles never seems to go away. This time a Canadian company called Current Technology Corporation develops a machine that uses low-level electric shocks to treat bald heads. They call the therapy ElectroTrichoGenesis. This electroshock treatment has not been proven to work any better than the electric comb of 1920
In San Francisco, I start taking a low dose of finasteride once a day to preserve my own hair.
1995
In an attempt to simultaneously solve the artificial hair appliance problems of secure attachment and easy removal for hygiene, Dr. Anthony Pignataro, a New York cosmetic surgeon, develops the snap-on hairpiece. In the first part of this new method of hairpiece attachment, surgical-quality titanium sockets are screwed through the scalp into the skull and allowed to fuse with the bone over a period of three months. Then, small gold-alloy snaps are screwed into the sockets. The snaps mate securely with attachments formed into the underside of a custom-made hairpiece.
1995
The FDA approves two percent Rogaine lotion as an over-the-counter drug, meaning it can now be sold without a prescription. Generic versions of minoxidil lotion become available in concentrations up to five percent, and are sold in supermarkets and drugstores.
1995
In the United States, micrografting evolves into Follicular Unit Micrografting and becomes the new state-of-the-art method of hair transplantation. The key to this technique is to identify and preserve the natural clusters of hair follicles from strips of donor tissue, minimizing cutting and risk of damage to the limited supply of donor follicles. In addition, the grafts are kept chilled and moist during all stages of the procedure to further reduce graft failure. I develop several improvements to instrumentation used in Follicular Unit Micrografting, including using cool fluorescent transillumination and a disposable clear vinyl cutting surface with stereomicroscopes during graft preparation.
1998
In Canada, a company markets a laser-light treatment that promises to stop hair loss and stimulate hair. With just two thirty-minute sessions twice-weekly, along with regular use of their own branded shower head filter, shampoo, conditioner, and nutritional supplements, they claim that seventeen of eighteen patients in their study showed absolutely no further signs of hair loss, and fifteen of eighteen people showed signs of new hair growth.
2000
A Portland, Oregon firm offers balding men and women the service of storing samples of their hair in a basement room for an annual fee, in the hopes that in the future a cure for baldness will require a hair sample. A staff writer for the San Francisco Chronicle interviewed Dr. Alexa Bower Kimball, a dermatologist at the Stanford University Medical Center, and asked if she could think of any reason why someone should bank a sample of his or her hair. Her answer: “Not off the top of my head.”
2000-2005
TODAY
Currently, the most effective cosmetic treatments for hair loss are wigs and hairpieces, which work regardless of the cause of the hair loss. The most effective medicines for androgenetic alopecia (hereditary pattern hair loss) are Propecia for men, and a combination of spironolactone and hormone therapy for women. The most effective surgical procedure for pattern baldness is follicular unit micrografting.
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